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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197407841
Report Date: 08/20/2019
Date Signed: 08/20/2019 12:32:36 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:CHILDREN'S PLACE, THEFACILITY NUMBER:
197407841
ADMINISTRATOR:PRECIOUS JOHNSONFACILITY TYPE:
850
ADDRESS:1215 CRENSHAW BLVDTELEPHONE:
(310) 328-6313
CITY:TORRANCESTATE: CAZIP CODE:
90501
CAPACITY:59CENSUS: 16DATE:
08/20/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
08:20 AM
MET WITH:Jennifer RichardsTIME COMPLETED:
12:45 PM
NARRATIVE
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On 8/20/19 at 8:20 AM Licensing Program Analysts (LPAs) Angelica Ramirez and Lourdes Castellanos arrived at The Children's Place licensed facility for the purpose of following up on the unusual incident that occurred on 7/22/19. The El Segundo Child Care Regional Office received the report on 8/6/2019. LPAs met with site director Jennifer Richards. Upon arrival LPAs observed four toddlers and 13 preschoolers present with four staff members.

According to the report, on 7/22/19 Child 1 was running to the bathroom and tripped and bumped his mouth. The child had a cut on his lower lip.

During this inspection, LPAs conducted interviews with staff and parents. LPAs conducted a tour of the classroom, obtained child's records and a copy of the sign in and sign out sheet dated 7/22/19.

Upon notification from Child 1's parents regarding extent of Child 1's injuries, facility failed to timely report the incident to the El Segundo Child Care Regional Office. Although the director left a message, the director failed to contact a live person to report. The facility also failed to contact Child 1's parents regarding the incident. Based on the information obtained throughout the course of the investigation, Type B citations will be issued today. See LIC 809-D.


An exit interview was conducted and a copy of this report, appeal rights and a Notice of Site Visit were provided to Jennifer Richards, Site Director.
SUPERVISOR'S NAME: Sharalyn Jenkins-SweetenTELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Angelica RamirezTELEPHONE: (424) 301-3071
LICENSING EVALUATOR SIGNATURE:

DATE: 08/20/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: CHILDREN'S PLACE, THE
FACILITY NUMBER: 197407841
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/20/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/20/2019
Section Cited
CCR
101212(d)(1)(B)
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Reporting Requirements. Upon the occurrence, during the operation of the child care center of any of the events specified in (d)(1) below, a report shall be made to the Department by telephone or fax
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Site director Jennifer Richards shall conduct training on reporting requirements and will provide a sign-in sheet along with notes from the training. Director shall provide the documentation by 9/20/19 via email.
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within the Department's next working day and during its normal business hours. Upon notification of extent of Child 1's injuiries, licensee failed to report the incident to the Deparment. This poses a potential health and safety risk to children in care.
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Type B
09/20/2019
Section Cited
CCR
101226(a)
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Health-Related Services. (a) The licensee shall immediately notify the child's authorized representative if the child becomes ill or sustains an injury more serious than a minor cut or scratch. The licensee shall obtain
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Site director Jennifer Richards shall conduct training on serious injuries/head injuries and requirement to contact parents as soon as possible and will provide a sign-in sheet along with notes from the training.
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specific instructions from the authorized representative regarding action to be taken. Licensee failed to contact parents regarding injury to Child 1, this poses a potential health and safety risk to children in care.
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Director shall provide the documentation by 9/20/19 via email.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Sharalyn Jenkins-SweetenTELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Angelica RamirezTELEPHONE: (424) 301-3071
LICENSING EVALUATOR SIGNATURE:

DATE: 08/20/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2019
LIC809 (FAS) - (06/04)
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